A paper form replaced by a scan.
QR Intake Setup
$50
Introductory pricing for our first five clients. Starting price — scope beyond the base package is quoted and approved before any work begins.
A simple, mobile-friendly digital intake form your customers reach by scanning a custom QR code. Put the code on a sign, a flyer, a business card, or a table tent — the information comes to you organized instead of on a clipboard.
Included in $50
- One intake form, up to 10 questions, built around yours
- Custom client questions — not a generic template
- Mobile-friendly layout that works on any phone
- Basic branding — your name, your colors, and your existing logo file applied
- Custom QR code file, standard black-and-white, print-ready
- Notification to you when someone submits
- A defined destination for every submission
- One round of revisions, returned as a single consolidated list within 7 days
Not included at this price
These are real capabilities NEXIS builds — they're listed here so the base price stays honest. Any of them can be added as an upgrade or a separate project.
- Complex conditional logic
- CRM implementation
- SMS automation
- Multi-stage workflows
- Payment processing
- Appointment automation
- Custom dashboards
- API integrations
- Advanced database architecture
- AI agents
Add-ons for this service
Extend it when you're ready.
Additional Form
from $25
A second (or third) intake form sharing the same branding and delivery setup.
Advanced Form Logic
from $25
Questions that appear or hide based on earlier answers, so people only see what applies to them.
Automated Confirmation
from $25
Your customer gets an automatic branded confirmation the moment they submit.
Scheduling Integration
from $25
Connect the form to your calendar so a submission can become a booked time.
Data Organization / Spreadsheet
from $25
Submissions land in a clean, sortable spreadsheet instead of a pile of emails.
Custom Branded QR Graphic
from $20
A print-ready designed QR asset — signage, flyer, table tent, or window decal.
Follow-Up Automation
from $75
Automatic follow-up messages after a submission, so nobody falls through the cracks.
How payment works
You see it finished before you pay.
- 01
Submit your intake
Free. No card, no commitment.
- 02
We confirm scope and price
Within one business day. Nothing starts until you approve it.
- 03
We build it
You get a preview of the finished form to review.
- 04
You pay
Invoice sent on approval.
- 05
We hand over
Your live form link and QR code file are released once payment clears.
Before you buy
This is a general business intake product. It is not built or priced for regulated sensitive data — it should not be used to collect protected health information, substance-use treatment records, or financial account data. Those workflows require different architecture, different safeguards, and separate pricing. If that's what you need, say so in your intake and we'll scope it properly instead of selling you the wrong thing.